Psoriasis in childhood and adolescence

Psoriasis starts in the first two decades of life in about one-third of patients. Initially the diagnosis may be difficult because of atypical or mild involvement. Plaque psoriasis is the most frequent type in children, just as in adults. However, lesions are often smaller, thinner and less scaly. Treatment of childhood psoriasis represents a special challenge to dermatologists since many therapeutic agents are not approved and guidelines are generally lacking for this age group. Apart from clinical type, severity of the disease and patient's age, the choice of treatment must be based on safety concerns and accessibility of treatment. We herein focus on the peculiarities of clinical presentations and on the management of psoriasis in children and adolescents.